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I am currently being treated by a neuromuscular dentist for my TMJ disorder. I have had Tens on my facial muscles to relax them, then something called jaw tracking where a magnet was placed inside my bottom lip to find the most comfortable position for the jaw muscles. Impressions were taken and then an orthotic was constucted to wear on my lower teeth 24/7 for a few months to see if it alleviates the symptoms I am having. Marked as spam
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Private answer
As both a dentist with 15 yrs experience of making orthotic splints and having worn them myself for many years, a splint should be tight enough to create a stable bite but not painful to wear. If after the first couple of days it is causing discomfort to the extent that you have to leave it out then it needs relieving. Night time wear is usually the most critical as it is during restless sleep that most parfunction (tooth grinding) occurs.
The neuromuscular approach is somewhat different to my training however in that I have always found that if the jaw joints are seated correctly and the splint creates harmonious function then the muscles will spontaneously relax (so called 'neuromuscular release')
I would always test this with a simple Lucia Jig appliance first to be certain that more complex, protracted and expensive splint treatment will be successful. This Jig is also a good way to relax the muscles to allow one to seat the jaw correctly.
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There are many different schools of thought re occlusal problems (bite problems). Some dentists will even say that TMJ problems are not related to occlusion. I personally do not believe in partial coverage splint but rather a flat plane full coverage appliance that should be very comfortable to wear and start to relieve symptoms within a few days. I would Advise looking for a dentist from the British society of occlusal studies www.bsos.org.uk. It is difficult to comment further without examining you and seeing the orthotic device . However in my experience partial coverage splints are to be avoided . Marked as spam
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Private answer
TMJ disorders are a very common complaint and have their origin in a whole host of different factors from the coverall of stress or stressful things such as hard work, house moves domestic disharmony etc to occlusal disharmony (uncomfortable bite) due to a high filling new crowns or occasionally an anatomical problem due to the way the jaws are related to each other and hence the way the teeth contact. As the condition usually has a multitude of factors creating the symptoms the dental and medical profession has created a multitude of cures - all of which can have some merit , from change in diet and simple analgesics, simple to complex 'orthotic' devices (to use the american parlance) to drug regimens and psychological treatments and in extremis surgery. All of the 'cures' have approximately the same success rate and will usually give some relief from the acute symptoms that you may be suffering. No treatment at all will usually have the same statistical success rate in the long term but this does not deal with your immediate problem. Using a pseudo scientific approach as you describe if carefully thought out and undertaken often has excellent success rates, the appliance should however not be uncomfortable to wear after a day or two and if it is it may be too tight or possibly the bite adjustment on it is inaccurate, as always an answer from a web page can never give you the full facts for your case and is just an overview therefore as you have paid a fee for the treatment and it appears not to be doing what you expect you should approach the provider of the treatment and get some help, if the appliance needs modification or remaking most would feel it reasonable that this should be included in your original fee - although if you have had specific consent for the procedure then it may be worth looking at your contract with the appliance provider. In summary, TMJ problems are common, they tend to get worse and improve all by themselves, acute symptoms can often be improved by use of an occlusal appliance or orthotic and some like all human problems will sadly never get better at all. It is however unlikely that you will ever be cured of your problems just alleviated of them for the majority of the time with the appropriate help. Richard Elsey BDS MSc FDS RCS Marked as spam
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